OPTIMIZING THE MANAGEMENT OF HEART FAILURE FROM …

OPTIMIZING THE MANAGEMENT OF HEART FAILURE FROM HOSPITAL TO HOME: TRANSLATING THE LATEST EVIDENCE INTO PRACTICE

This CME activity is provided by Integrity Continuing Education. This CE activity is jointly provided by Global Education Group and Integrity Continuing Education.

Faculty Affiliation

Anekwe Onwuanyi, MD, FACC Professor of Medicine Chief Cardiology Section

Morehouse School of Medicine Atlanta, Georgia

Faculty Disclosures

? Dr. Onwuanyi has no real or apparent conflicts of interest to report.

Learning Objectives

? Assess the type, stage, and functional classification of heart failure in hospitalized patients

? Develop a patient-centered, guideline-directed, evidence-based management plan for patients hospitalized with heart failure with reduced ejection fraction (HFrEF)

? Integrate data on newer agents approved for HFrEF to ensure safe and appropriate administration in patients shortly after an acute episode

? Discuss the FDA recall of common heart failure medications and which agents have and have not been recalled

? Apply effective transitions of care strategies for the management of patients with HF

INTRODUCTION

National Average Readmission Rate (%)

Medicare Readmission Rates Among Patients Hospitalized for Heart Failure

26

25

24

23

24.5

24.7

24.8

24.7

Diagnosis for Initial Hospitalization

Heart Failure Heart Attack Pneumonia

22

21

19.9

19.9

19.8

19.7

23.0

22.7

22.0

20

19

18.3

17.8

18

17.0

17

18.2

18.3

18.4

18.5

16

17.6

17.3

16.9

15

July 2005-June July 2006-June July 2007-June July 2008-June July 2009-June July 2010-June July 2011-June

2008

2009

2010

2011

2012

2013

2014

Performance (Measurement) Time Period

Despite recent decreases, a significant percentage (22%) of patients hospitalized with heart failure are readmitted within 30 days.

Boccuti C. and Casillas G. Aiming for Fewer Hospital U-turns. Issue Brief. March 2017.

Mortality of Heart Failure

? Underlying cause of death in 75,251 people in 2015

- 33,667 males - 41,584 females

? Survival has improved due to evidencebased approaches to treat risk factors and appropriate medical therapy

- Mortality remains high

Every 1 in 8 deaths has heart failure mentioned on the death certificate.

Benjamin EJ, et al. Circulation. 2018;137:e67?e492.

Case Fatality Rates After Hospitalization for

Heart Failure

42.3%

10.4%

22.0%

30-day 1-year 5-year

BEST PRACTICES FOR DIAGNOSIS, ASSESSMENT, AND MONITORING OF HF IN THE HOSPITAL SETTING

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